One-Stage Debridement and Bone Grafting With Internal Fixation via Posterior Approach for Treatment of Thoracic Spine Tuberculosis

Abstract

The study aimed to investigate the clinical efficacy and feasibility of one-stage surgical treatment for thoracic spinal tuberculosis by internal fixation, debridement, and combined interbody and posterior fusion via a posterior-only approach. A total of 12 patients (8 male, 4 female) with thoracic tuberculosis whose lesions were confined to 2 adjacent segments were admitted to our hospital. The American Spinal Injury Association (ASIA) impairment scale was used to assess neurologic function. All patients were treated with one-stage surgical treatment by internal fixation, debridement, and combined interbody and posterior fusion via a posterior-only approach. Patients were evaluated preoperatively and postoperatively by measurement of thoracic kyphotic angles using Cobb angle evaluation, determination of erythrocyte sedimentation rate, evaluation of ASIA impairment scale, and radiologic examination. Operation time ranged from 60 to 150 minutes (average, 120 minutes). Intraoperative blood loss ranged from 300 to 850 mL (average, 500 mL). All patients were followed up for 24 to 48 months postoperatively (average, 32 months). No sinus tract formation, cerebrospinal meningitis, or recurrence of tuberculosis occurred. All patients had significant postoperative improvement in ASIA classification scores. The thoracic kyphotic angles were significantly decreased to 12° to 30° postoperatively, and at final follow-up were 14° to 28°. The erythrocyte sedimentation rate recovered to normal within 6 months postoperatively in all patients. Bone fusion was achieved within 3 to 6 months (average, 5 months). One-stage surgical treatment for thoracic spinal tuberculosis by internal fixation, debridement, and combined interbody and posterior fusion via a posterior-only approach can be an effective and feasible treatment method.